Settlement Submission Form
 Annuity Settlement Submission Form

Please Fill Out Form Below and Check All That Apply.  Please Answer All Questions and Hit 'Submit' When You Are Finished.
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You were not informed of the heavy penalties to get out of your annuity
You were not given a prospectus for your annuity at the appropriate time
You were misled about how much the annuity may earn
You were given any unreasonable expectations about the annuities performance or benefits
You were told you could get a stock market return without stock market risk
You were told you could receive a worthwhile lifetime income or withdrawal benefit
You were not informed of the punitive way your annuity is taxed---Non-IRA Accounts
Your annuity would permit you to qualify for Medicaid or other state benefits
You were told that an annuity was needed to avoid probate
You were not provided with an example of how the annuity benefit worked and impact of the chrages
You were told that an annuity was better than other investments
You made less money than you expected from your annuity
You were not told about the limited liquidity of your annuity
You learned you could not get certain annuity benefits without receiving payments over many years
You were sold an annuity without being informed of other investment alternatives
You have other reasons which may lead you to believe your annuity was unsuitable
If you qualify please indicate when you would like to be contacted:
Additional Comments or Concerns:
Confidentiality of Your Information: Any information you submit in connection with your case will be used solely to review your situation, calculate damages, and assert a claim on your behalf. Absent additional written authorization from you, your information will not be shared with anyone other than the program's analysts and/or consulting attorneys in connection with your claim.
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